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関連する概念動画

Methods of Documentation II: POMR01:26

Methods of Documentation II: POMR

The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.
Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
Methods of Documentation V: CBE01:23

Methods of Documentation V: CBE

Charting by Exception, or CBE, is a method of documentation used in healthcare, particularly in nursing, that focuses on documenting only significant or abnormal findings rather than recording every detail. This approach aims to streamline the documentation process, improve efficiency, and ensure that healthcare providers can quickly identify deviations from normalcy in patient assessments.
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Health Information Technology and Healthcare Information System01:30

Health Information Technology and Healthcare Information System

Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:

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関連する実験動画

Updated: May 18, 2026

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
06:55

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index

Published on: January 8, 2020

メディケア医師グループ実務デモに関連する支出の差異.

Carrie H Colla1, David E Wennberg, Ellen Meara

  • 1Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, 35 Centerra Pkwy, Lebanon, NH 03766, USA. Carrie.H.Colla@Dartmouth.edu

JAMA
|September 13, 2012
PubMed
まとめ

Medicare Physician Group Practice Demonstration (PGPD) は,全体的なコスト削減が控えめで,メディケアとメディケイドの双重資格を持つ受益者に集中した大幅な節約が示されました. 参加した医師グループの中には,かなりの節約を達成した医師グループもあれば,そうでない医師グループもいた.

関連する実験動画

Last Updated: May 18, 2026

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
06:55

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index

Published on: January 8, 2020

科学分野:

  • 健康経済学 医療経済学
  • 保健医療政策について
  • 医療の質の向上 医療の質の向上

背景:

  • メディケア・メディケイド・サービスセンター (CMS) は,医療の質を向上させ,費用を管理するために,アカウンタブル・ケア・オーガナイゼーション (ACO) プログラムを導入しました.
  • Medicare Physician Group Practice Demonstration (PGPD) のパイロットはACOに先立ち,医師団が質目標を達成し,コストを削減するために金銭的インセンティブを提供しました.
  • PGPDは質の改善を示したが,医療費への影響は不明であった.

研究 の 目的:

  • PGPDの全体的なコスト削減を決定する.
  • メディケアとメディケイドの双重資格を持つ受益者のためのコスト削減を具体的に推定する.

主な方法:

  • 介入前 (2001-2004) と介入後 (2005-2009) の支出動向を比較した準実験的な設計が採用されました.
  • 介入グループには,PGPD医師が治療した990,177人の有料メディケア受給者;対照グループは,同じ地域から7,514,453人の受給者を含む.
  • 受益者一人当たりの年間支出が主な成果指標であり,ケースミックス分析には様々なリスク調整方法が使用されました.

主要な成果:

  • 総額として,受給者一人当たりの年間貯蓄は控えめでした (調整平均114ドル).
  • 相当な節約は,二重資格の受給者 (532ドルの調整された平均値) に見られたが,二重資格の受給者でない受給者には見られなかった.
  • 支出削減は主に急性ケアで,参加医者のグループ間で貯蓄の顕著な変動がありました.

結論:

  • PGPDは一部の機関で大幅な節約を達成しましたが,これは他の機関での節約の欠如によって相殺されました.
  • ほとんどのコスト削減は,メディケアとメディケイドの双重資格を持つ受益者の間で実現されました.
  • 調査結果は,医療費に対する実践に基づく支払いモデルの異質な影響を強調しています.